Individual provider Active NPI

Lulette Lipumano-Sanchez, D.D.S.

  • Dentist
  • San Jose, CA
National Provider Identifier
1710179387
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50950 Issued in CA
Practice address
6223 Tillamook Dr
San Jose, CA 95123-4752
Phone
(408) 655-3987
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50950 CA Primary

Addresses

Primary practice location

6223 Tillamook Dr
San Jose, CA 95123-4752

Mailing address

6223 Tillamook Dr
San Jose, CA 95123-4752
Phone (408) 655-3987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825001882 CA Order and Referring Only - DentistPractitioner - Dentist 1052683026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50950CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lulette.lipumano-sanchez.1@17661.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1710179387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 TILLAMOOK DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951234752",
            "telephone_number": "408-655-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 TILLAMOOK DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951234752",
            "telephone_number": "408-655-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPUMANO-SANCHEZ",
        "first_name": "LULETTE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.